Laparoscopy in trauma. When and how to use this approach?

Surgery & related medical specialties

Introduction: Trauma is one of the leading causes of death and disability worldwide. Laparoscopy has shown to have an advantage over traditional surgical techniques in several areas; however, its use in the evaluation and treatment of trauma has been scarce. Material and Methods: A recent literature search of the relationship between laparoscopic surgical techniques and trauma was performed in PubMed, Cochrane Library, EBSCo Host, IMBIOMED and Medigraphic databases (words MESH laparoscopy, minimally invasive and trauma). Clinical vignette: An 80-year-old man was admitted with a history of being run over. He was diagnosed with hypovolemic shock grade IV, fractures of the right costal arches and fracture of the pelvis Tile B. He required external fixation and intensive care unit management; despite this, he persisted with hemodynamic instability and diagnostic laparoscopy was performed. Discussion: A meticulous initial evaluation is necessary; the lack of a diagnosis of certainty requires further investigation; treatment should be individualized and there should be no obvious indication for laparotomy. Conclusions: There is evidence in the literature to affirm that laparoscopy is effective and sometimes superior to conventional laparotomy for the evaluation and treatment of trauma victims.

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